CGRP for Migraine: Setting the Right Expectations

During the 60th Annual American Headache Society (AHS) Scientific Conference in San Francisco, I had the distinct pleasure of sitting down with Dr. David Dodick, professor of neurology and a headache specialist at the Mayo Clinic in Phoenix, Arizona. Dr. Dodick is the Medical Director of the Headache Program as well as the Concussion Program. He is a past president of AHS and of the International Headache Society. Dr. Dodick has authored more than 280 peer-reviewed publications and coauthored 8 books.

CGRP clinical trial results

“The way we define clinical response is going to be different than in clinical trials and it’s going to be the patient who defines whether or not he or she is responding.”

A patient trying the first CGRP inhibitor has a 1 in 5 chance of not responding at all, but “the good news is that there is more coming.”

Optimistic about the future of migraine treatments

Dr. Dodick admits that he also has to set his own expectations of how his patients are going to respond. Truly an optimist, he’s disappointed that a patient doesn’t have more relief based on the clinical trial criteria, but to a patient who experiences a decrease in the average severity of their migraine can be truly life changing. “I have to adjust my expectations because patients are grateful for anything you can do for them.”

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Comments

As a migraineur, expectations are high, but so is the fear that, as has happened so many times before, it won’t work. It’s so exhausting to get your hopes up with each new treatment you try, only to have them dashed when they either don’t work at all, or quit working after only a short time.

I have participated in a CGRP study at Jefferson Headache Center, in Philadelphia under Dr. Silberstein for the past 5 years. The past 4 years I have received the drug. It has been life changing for me. I was getting, at the least, 1 migraine/week. I now get less than 1 migraine/month. My quality of life before the study was nil. I now have my life back. This medication is truly groundbreaking and I hope they can develop a different form that more migraine sufferers will respond to it. For all migraine sufferers, it’s worth a try.